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Conscious sedation and asthma

Hi all, 

i was wondering if I could ask you all about any experiences with conscious sedation for procedures and asthma? Has it ever been an issue with your anesthetists? Did you check with your pulmonologist before going forward? 

I’ve been struggling with gerd/lpr and recurrent nausea + lower gi troubles. I saw my pcp today and he’s concerned about the chest pain, new weight loss, fatigue and persistent nausea despite high dose lansoprazole. Today we switched to protonix and he ordered an egd with biopsies. 

All of my lung function tests are improving, but the idea of sedation is a little scary. 😬 I underwent general anesthesia last June without issue, but the lungs were not nearly as bad.

Thanks for your thoughts! Em

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  • dory2005

    Em, I completely understand being nervous about it!  I've had conscious sedation for gum surgery and dental surgery about five years ago, but that was before my asthma took a turn for the worse. It still caused me to have a slight flare, and that was when my asthma wasn't nearly this bad. (I have issues with sedatives/pain meds suppressing my 02 levels.) I'd check with your pulmo. My pulmo is very aggressive with treatment, but very cautious with any type of surgery. When I broke my shoulder in three places last year, he said it would be *disastrous* for me to have surgery and the ortho agreed, but that would have been general anesthesia, and I was in the midst of a full blown flare and bronchitis at the time. 

    I hope you get some guidance with this! I know it can be nerve-racking! 

     

  • Emelina

    Thank you Dory! Last week I had some pretty hefty bronchospasm which dropped my sats to 89-90% and I needed to neb through the day. I know they’ll watch me closely while I sleep, I just don’t want to add insult to injury to the poor lungs.

    Thank you for sharing your experience with oral surgery and your shoulder! I’m glad they didn’t go ahead at that time. I can’t imagine a big surgery under general anesthesia + flare + bronchitis. I hope the shoulder is fully healed and feeling back to normal! Ouch!! 

    I’ll touch base with my pulmo.

  • Shea

    I did a heart cath with conscious sedation. We pretreated with a small prednisone boost since I was on prednisone regularly and concerned about my body's ability to handle extra surgical stress when my body us not used to making extra cortisol and normal people naje extra cortisol naturally during procedures sbd surgery. Im glad I pushed for the extra prednisone. Thete were no complications and my asthma actually improved with that pred boost. 

  • Melissa G

    Bekah has never had conscious sedation, but she gets general anesthesia several times a year. We make sure she takes her Advair and we pre-treat with albuterol before any/all procedures. She has only struggled a hand full of times after. You can call and speak with an anesthesiologist before the procedure. We have done that, we have also made an appt to actually meet with an anesthesiologist before a big surgery. 

  • dory2005
    Emelina posted:

    Thank you Dory! Last week I had some pretty hefty bronchospasm which dropped my sats to 89-90% and I needed to neb through the day. I know they’ll watch me closely while I sleep, I just don’t want to add insult to injury to the poor lungs.

    Thank you for sharing your experience with oral surgery and your shoulder! I’m glad they didn’t go ahead at that time. I can’t imagine a big surgery under general anesthesia + flare + bronchitis. I hope the shoulder is fully healed and feeling back to normal! Ouch!! 

    I’ll touch base with my pulmo.

    Ironically, the ortho was shocked at how well my shoulder healed. He said it healed better than it would have with surgery and my range of motion was just as good as it would have been with surgery.     

  • Emelina

    Shea, I’m so glad you got an extra boost of steroids prior to your procedure. It is a more than little nerve wracking to consider how prednisone impacts our body’s ability to handle physiologic stress. 

    Melissa, great idea about talking to the anesthetist before and pre treating! Thanks! 

    Dory, that’s awesome that you healed so well! 

  • Pljohns

    I had anesthesia last Oct to have my gallbladder removed.  It was a tough go.  The surgeon talked to the anesthiologist prior to the procedure and he told me they would give me a neb just before I went back and they would have a neb waiting in recovery. They did, but it wasn't enough-I went through 2 albuterol nebs in less than an hour and they wouldn't give me any more but thankfully DH was there with my neb and levabuterol (less cardiac issues) so they agreed to let me use that.  i still had issues-it took 4 nebs to get me sort of OK.  When  I saw the pulmo, I told him about it and he said that for that particular surgery, you generally lose 27% of your lung capacity for a day or so.  All I know is it was tough going.  

    I was "twilighted" for a colonoscopy 5 years ago too and needed a neb as soon as I came to in recovery.  My asthma just doesn't like sedation in any form.

  • Emelina

    Thank you Lynn for sharing your experience. Abdominal surgeries are always tough because people splint afterwards due to pain, and laparoscopic procedures push up on the lungs from the co2 they put in the abdominal cavity. I’ll be sure to bring some levalbuterol along. Appointment with the surgeon is later this week. 🙏

  • Kathy P

    I have 2 wrist surgeries in the past year with sedation. I've had a couple of scopes in the past too, but that was before my asthma was as bad as it is now. I too was a bit concerned about my asthma.

    I made sure everyone knew about my asthma.

    Our surgi-center has different folks call prior to the procedure. One call was from the anesthesiologist. They went over the when to stop eating and drinking and what meds I was taking. I made sure he knew about my asthma and asked specifically about taking all of my allergy/asthma related meds the day of. He also recommended bringing my quick-relief inhaler along.

    You can also check in with your asthma doc to see if they recommend any change to treatment prior to the surgery to have your lungs in the best possible condition.

     and 

  • Emelina

    Thank you Melissa and Kathy. consult visit went well. Egd with biopsies and ph probe placement scheduled for mid July.